Nasal cannula are conventionally held in place by adhesive tape placed across the nose, forehead or cheek of the patient.
These areas are characteristically oily, thus greatly reducing the holding power of the adhesive.
The procedures for which these tubes are used generally involve either the introduction (gavage) or evacuation (lavage) of fluids to/from the patient's stomach. The presence of any of this fluid on the tape or surrounding skin areas will cause a loosening effect upon the adhesive.
The tubes are usually placed in patients that are critically ill, and which exhibit various symptoms of shock. One of the most common of which manifests itself as facial perspiration, thereby greatly impairing the adhesive characteristics of the tape.
The skin of the face is quite sensitive, and a number of people exhibit immediate allergic reactions to adhesive tape. Many other people develop a sensitivity after varying periods of time. This secondary reaction is often seen as reddening and blistering of the skin beneath and around the taped area. These reactions are present in both the male and female, and depend to a great degree upon the individual. In both critical-intensive and extended care situations (where long term usage of such tubes is common), this sensitivity could easily result in rapid tissue breakdown, sloughing, and the onset of infection. Infection, however slight, in these situations could prove extremely dangerous. This would also provide no sound alternative for retaining the tube once this situation had arisen.
Endotracheal tubes are used during major surgical procedures to insure a maximum airway is available and to provide proper ventilation of the patient under general anesthesia.
They are also used to provide an artificial airway in emergency situations where the larnyx is swollen or spasm restricted, or the patient is unconscious and an airway is deemed necessary in the event that immedite resucitation is needed.
They are also used in patients where an airway is continually maintained, such as intensive care units or extensive care facilities.
Adhesive tape, secured across the patient's cheek, is commonly used as a secondary means to hold endotracheal tubes in place. Their primary means is an inflatable cuff at the distal (larnyx) end that when inflated presses against the walls of the larynx holding it in place. However, improper inflation, leakage, or accidental deflation of this cuff immediately transfers the security (life-supporting) retention of this tube to the adhesive tape -- therefore, it is of vital concern.
Since the endotracheal tube is introduced into the larnyx by means of the mouth, there is always some moisture involved. It is not uncommon at all for the adhesive tape to come loose in even the most controlled of situations.
The retention of this tube is obviously a critical factor. The loss of the airway it provides has proven fatal -- since reinsertion of the tube can often be difficult if not impossible because of a swollen or spasmed larnyx. And an emergency tracheotomy consumes critical minutes that the brain goes without oxygen.
The aforementioned allergic reactions to this adhesive tape method also apply here. Perhaps to an even greater degree, since larger strips of tape are commonly needed to hold this larger tube.
Another problem would be that taping a tube in this area is extremely difficult, if not impossible, in bearded individuals.
Prior art headband mounted cannula holders are known as represented for example by U.S. Pat. Nos. 2,735,432; 2,931,358; 3,161,199; and 3,648,703. However, these prior art type of holders have presented various problems such as the following:
They necessitate auxiliary adhesive tape mounts.
They are not elastic to permit movement and comfort while holding the cannula firmly in proper position.
The tubes are bent or held so they may become fouled or pinched.
They are not held in the proper place for comfort and avoidance of skin or tissue irritation.
They do not firmly grasp the cannula to prevent axial or lateral movement.
They do not hold the cannula in place to observe the contents.
They provide constructional features which will accumulate mucus, secretions or bacteria in an unsanitary manner.